Pavlovian disgust conditioning as a model for contamination-based OCD: Evidence from an analogue study

Abstract

Pavlovian fear conditioning provides a model for anxiety-related disorders, including obsessive-compulsive disorder (OCD). However, disgust is the predominant emotional response to contamination, which is a common theme in OCD. The present study sought to identify disgust conditioning abnormalities that may underlie excessive contamination concerns relevant to OCD. Individuals high and low in contamination concern (HCC, n = 32; LCC, n = 30) completed an associative learning task in which one neutral face (conditioned stimulus; CS+) was followed by a disgusting image (unconditioned stimulus; US) and another neutral face (CS−) was unreinforced. Following this acquisition procedure, there was an extinction procedure in which both CSs were presented unreinforced. The groups did not show significant differences in discriminant responding to the CSs following acquisition. However, following extinction, the HCC group reported less reduction in their expectancy of the US following the CS+, and also reported greater disgust to the CS+, compared to the LCC group. Increased disgust to the CS+ following both acquisition and extinction was correlated with increased symptoms of contamination-based OCD and increased disgust sensitivity. Additionally, disgust sensitivity mediated group differences in disgust responding to the CS+ at acquisition and extinction. Also, failure to adjust US expectancy in response to extinction partially mediated group differences in disgust to the CS+ following extinction. Together, these findings suggest that excessive contamination concerns observed in OCD may be related to difficulty inhibiting acquired disgust, possibly due to elevated disgust sensitivity that characterizes the disorder.

Acquisition and maintenance of disgust reactions in an OCD analogue sample: efficiency of extinction strategies through a counter conditioning procedure

“…One hundred and sixty-two lay people were tested using Padua's inventory contamination subscale (PI-C, Sanavio et al, 1998), to identify people with low and high contamination-related concerns. In line with other studies (Armstrong, 2017, Deacon & Maack, 2009, Deacon & Olatunji, 2007. Conform to Armstrong's work (2016), individuals with scores greater than 13 (77 : 47.53% of the sample tested) were considered eligible for the group with high concerns about dirt and contamination (HDCC) and individuals with scores below 7 (42 : 27.92% of the sample tested) were considered eligible for the group with low concerns regarding dirt and contamination (LDCC).…”

Conditioned Fear Extinction, Neuropsychological, and Psychological Aspects of OCD in Latinos

“…Nevertheless, this outcome would likely be different if the fear conditioning and extinction paradigm consisted of common themes relevant to OCD. For example, Armstrong and Olatunji (2017) used an associative learning task that showed a neutral face that was followed by a disgusting image (unconditioned stimulus) and a neutral face that was not paired with a disgusting image (CS-) and found that individuals with high and low contamination concerns did not differ in discriminant responding. However, those with high contamination concerns, who exhibited symptoms consistent with individuals with OCD, reported more considerable disgust to the CS+, and their unconditioned stimulus expectancy during the CS+ was resistant to extinction.…”

Design and Validation of Augmented Reality Stimuli for the Treatment of Cleaning Obsessive-Compulsive Disorder

“…Among the examples that were mentioned repeatedly in relevant studies are decomposed food (such as rotten meat or food with mold), objects on which dirt can be observed, and objects the person considers can transmit contamination because they were or are in contact with objects, people, or places infected or dirty (Breiter et al, 1996;Rachman, 2004;Armstrong and Olatunji, 2017;Mathes et al, 2019). Based on this, the four aversive stimuli developed in this project were a sealed plastic bag (full of garbage), bread with mold, rotten meat, and sports shoes with dirt on their surface.…”

“…From the results found in the literature review four AR stimuli were developed (Breiter et al, 1996;Rachman, 2004;Armstrong and Olatunji, 2017;Mathes et al, 2019). These stimuli aimed at causing the emotions experienced by the people who suffer from cleaning OCD.…”

“…The stimuli mentioned were a garbage bag (Breiter et al, 1996), a loaf of bread with mold (Armstrong and Olatunji, 2017), a dirty sports shoe (Mathes et al, 2019), and a piece of meat in decomposition (Rachman, 2004). The app makes it possible to present each stimulus by means of a tablet or low-cost VR headsets such as Google Cardboard 2.0, to facilitate personalized exposure.…”